When we start esrd, we are by law informed of other modalities. Since this is usually done by the social worker working for the HD unit, there's little more said than, "would you like a transplant.?"
well I've spent seven years on HD asking opinions of Nephs, patients, techs, about which is better, which is more survivable. I get no answers. When told about transplant availability, there is no mention of impact from antireg drugs. No mention of seven year average life of new kidney. All I want to know is... if you want to live a long life, which is better, HD, PD or transplant. Anybody have the cojones to answer?

m micone,

"Cojones" has nothing to do with it. There are many people from all modalities that live long and fruitfull lives.

I personally know of a transplant (cadaver)patient that has been going strong for almost 30 years and a few others that are pushing 20 years, a number of PD patients that have been going for 20+ years as well as HD patients for the same length of time.

It's not that no one is giving you an answer, its that you're asking a question that has no answer.

Chuck

Hi:

In my personal opinion, if you qualify for a transplant, that's the route to go.
That's not to say, however, that - like Chuck - I've run across some patients who have refused the transplant list in favor of continuing home dialysis and are doing wonderfully.
Of those who don't have the option of a transplant, many are leading near normal lives (i.e. jobs, travelling, etc.) and have done so for years.
Anti-rejection drugs are better than ever, with far fewer side effects, so I personally would never consider that a reason to refuse a transplant.
And it's a crap shoot, trying to decide which decision is going to give you the longest life. We can all get hit by a bus tomorrow.
Interesting question, though, and I look forward to other replies.
Best,
Mike

I enjoyed the 2 1/2 yrs of HD (in a hospital
self care unit).
I am now 2 yrs. post cadaver transplant
and am doing well. The Anti Rej. drugs are
somewhat of a concern although I have
no problems, ..yet.
However, I was fortunate to receive a
near-perfect match.
Some of my dialysis partners have refused
kidneys that were not a "great match".
I tend to agree with them.
Art

I have been on dialysis for about three
years now and have been researching and asking the same question. One thing I did find that I was not too happy about is that I now am taking about 12 pills a day for various thngs afer the transplantI would be taking 50 a day and wth my insuranc paying only 80% that will be aproximately $2000 a month verses $480. Plus I personnally knew two pleople in my unit that had a transplant, one died two months after due to complications and the other is back on dialyis. Nope, transplant is not for me.




[This message has been edited by Michael Williams (edited 06-30-2004).]

It is up to patient to decide on these two alternatives. No one is perfect. Dialysis means gradual development of osteoporosis, muscle twitches, itching, headache, problems with heart, insomnia... Transplant means damage of your immune system and you are likely to be attacked by viruses (cytomegalovirus), osteoporosis, sometimes troubles with liver or stomach, limitation of sunbathing due to the possibility of getting skin cancer...

Hi:

While I understand there are problems associated with transplants, I do believe the last two posting are a bit negative.
I received a transplant four years ago and take eight pills daily. Even immediately after the transplant, I took no where near 50 pills. (Perhaps the writer has other, unmentioned, problems.)
ALL medications, for example, list dozens of "possible" side effects. Most users experience none.
Now a transplant is a serious undertaking, but in my mind it's still the best choice, except in a few instances.
I've had the pleasure of meeting many people who have had transplants for 20 years or more.
Yes, transplant patients are vulnerable to some medical problems, as radosko says, but, to take one examplle, the increased chances of skin cancer is less than five per cent. Wear the proper protective lotion and you lessen that possibility even more.
You have more of a chance of developing deep wrinkles from exposure to the sun than skin cancer if you take proper precautions.
In the end, it is up to the patient, but they must be in a position to made a fully informed evaluation.



[This message has been edited by Michael Williams (edited 06-30-2004).]

I imagine it would be a most difficult situation to be in... however,,, thnk it through and get as much info as you can, which ou are doing.... and goodluck...

as far as the pills, there are many drug companies that offer programs if you are on limited income.. you can get the drugs free....alot of the companies don't advertise.. there must be, i would think, or one would think..............the companies with the drugs u need could work something for paitents who could not af ford the meds needed after transplant... check it out.. just a thought.. good luck

quote:

Originally posted by altagrace:
I have been on dialysis for about three
years now and have been researching and asking the same question. One thing I did find that I was not too happy about is that I now am taking about 12 pills a day for various thngs afer the transplantI would be taking 50 a day and wth my insuranc paying only 80% that will be aproximately $2000 a month verses $480. Plus I personnally knew two pleople in my unit that had a transplant, one died two months after due to complications and the other is back on dialyis. Nope, transplant is not for me.


[This message has been edited by Michael Williams (edited 06-30-2004).]

I don't agree or disagree with transplants, I had a cadavar kidney in 88' after being on dialysis for over 12 years. Yes the drugs were harsh and I had many side effects. The worst part was That I shook so badly I could not do the thing I loved most, Quilting. The kidney was not a good match and the docs tried to sustain me with more and more drugs! When I finally couldn't handle it anymore, I asked the docs to cut back on the cyclo and let whatever happens, happen. Well I started feeling better and my creatnine dropped, For a while. But I did go back on dialysis 1 year after I recieved the kidney! But I felt so much better becouse the kidney wasn't working as well as the dialysis. But I tell many new patients to go for it, That I never regreted doing it. But as for me, the docs are wasting their breath when they ask me about going on the trans plant list!

I read through this whole thread. I have a few things to say.

1. which is better, HD, PD or transplant. Anybody have the cojones to answer? I can understand the frustration of not getting any answers or basic answers when you want more info. I also realize the answers you get may be based on word for word how you worded the question when really all you are asking for is more info so you can make your own decision (because in the end only you can make that choice). I would say PD is better than HD from personal experience but I would definately go for a transplant BUT I really REALLY REALLY wish SOMEONE would have told me about those terrible drugs and stop down playing it! Why? Because doctors and nurses are so used to dealing with them that they think it is not big deal but for a patient who does NOT know what to expect, the drug's side effects ARE a big deal! Even if they only get ONE side effect!!!

I am speaking as a patient from personal experience. I did NOT like being a 16 year old fat and hairy girl with a deep voice and terrible stretchmarks in a school kilt. Especially when I was told all along that I would have a NORMAL life after the transplant. Ya right!

2. I had my transplant for 11 years and the medications I was on were from 1990. I do believe people when they say the drugs are better now. And looking back, even WITH those side effects, I WOULD say it WAS worth it! I finally had a relatively "normal" life for those 11 years where I finally made friends (I never had any for the first 16 years of my life because I had no energy and stayed to myself) and got to grow up and catch up. yes, it was worth it!

3. [quote="<radosko>"]It is up to patient to decide on these two alternatives. No one is perfect. Dialysis means gradual development of osteoporosis, muscle twitches, itching, headache, problems with heart, insomnia... Transplant means damage of your immune system and you are likely to be attacked by viruses (cytomegalovirus), osteoporosis, sometimes troubles with liver or stomach, limitation of sunbathing due to the possibility of getting skin cancer...[/quote]

That was the MOST HONEST response I have EVER heard! And then Michael Williams goes and says it is negative? Damn maybe people should BE more negative and STOP PROTECTING us patients! If someone would have STOPPED protecting me as a teen then I would not have stopped my medication upon getting all those side effects and going through depression so bad I became suicidal!

Stop protecting us and just give us the darn facts already! That is all we are asking!

4. [quote="Michael Williams "]ALL medications, for example, list dozens of "possible" side effects. Most users experience none.
[/quote]
What planet are YOU on? I have had so many side effects that I know you are wrong about that! Especially Prednisone and Cyclosporine! Of course NOW drugs have improved but my docs say they will STILL put me on those

5. in the end only YOU can decide which is BEST for YOU .. but Please get ALL the facts before you decide and don't let ANY doc talk you into any certain one! Trust me! They have been wrong about their suggestions for me before!